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Exercise in Testicular Germ Cell Cancer Survivors

Not Applicable
Active, not recruiting
Conditions
Testicular Germ Cell Tumor
Interventions
Behavioral: aerobic-strength exercise intervention (6-months)
Registration Number
NCT05063760
Lead Sponsor
Slovak Academy of Sciences
Brief Summary

Regular exercise is effective in prevention \& treatment of chronic diseases. Exercise can reduce late toxicity of chemotherapy, commonly found in cancer survivors, which is yet to be translated into clinical practice.

Mechanisms of exercise benefits in oncologic patients are far from being elucidated, and include increase in muscle mass, reduction of fat mass, systemic inflammation and cardiometabolic risk. Synchronization of exercise adaptive response is, to an extent, mediated by bioactive molecules released from muscle, with anti-inflammatory \& tumor-suppressing properties. Muscle satellite cells are a source of regeneration, muscle structural integrity \& functional capacity. Phenotypes of muscle cells, such as secretory profile, lipid \& glucose metabolism, mirror clinical phenotypes of the donor. Importantly, muscle cells' metabolism in vitro can be modulated by 8-12 week training in vivo. Epigenetic mechanisms regulating muscle \& systemic metabolism in cancer survivors are not yet understood.

Detailed Description

Aims:

* To assess the impact of 6-month supervised, individualized aerobic-strength exercise training intervention in cancer survivors with chemotherapy-induced late toxicity . (i) on the whole-body energy and glucose metabolism, anthropometric parameters, physical fitness \& activity profile, motor functions and quality of life in testicular germ cell cancer (TGCC) survivors, more than 3 years after cisplatin-based chemotherapy; with the 2-year follow up; . (ii) on skeletal muscle mass, morphology as well as functional and metabolic state detected in vivo (31P-MR spectroscopy).

(iii) on metabolic characteristics of primary skeletal muscle cells;

* To determine the impact of exercise intervention on circulating bioactive molecules (exerkines), putative mediators of exercise health benefits as well as on levels of circulating inflammatory cytokines, which likely contribute to the pathogenesis of chemotherapy-induced late toxicity;

* To evaluate the role of (a) selected exercise-regulated bioactive molecules, (b) exercise-mimicking treatment (by electric pulse stimulation) and (c) cisplatin treatment on metabolism and mitochondrial function of differentiated human muscle cells in culture;

* To investigate the associations between intervention-induced shifts in circulating bioactive molecules and selected metabolic, anthropometric and motor parameters.

The generated results will enable us (i) to gain a better insight into pathomechanisms of muscle-associated chemotherapy-induced late toxicity and the role of skeletal muscle \& systemic mediators in the exercise-induced health benefits in TGCC survivors; and (ii) to validate the effectiveness of the individually-tailored exercise intervention in reducing chemotherapy-related toxicity in patients with TGCC, with the aim to transfer this knowledge into clinical practice.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
60
Inclusion Criteria
  • TGCT survivors, with chemotherapy-induced metabolic toxicity, men, 25-55 years old, with the capacity to undergo training, signed written informed consent
Exclusion Criteria
  • serious / uncontrolled chronic diseases, non-compliance, other health issues as assessed by oncologists / investigators

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TGCT patients - exerciseaerobic-strength exercise intervention (6-months)TGCT survivors, men, 25-55 yrs old, 3 and more years after successful treatment of TGCT, with the capacity to undergo aerobic-strength intervention assessed by cardiologist
Primary Outcome Measures
NameTimeMethod
change in the glucose toleranceparameter will be measured before and after 6 month intervention

change in glucose tolerance (as measured by oral glucose tolerance test)

change physical fitnessparameter will be measured twice before and after 6 month intervention

VO2max (mlO2 per kg BW min) as measured by bicycle spiroergometry

change in resting energy expenditiure and metabolic substrate preferenceparameters will be measured twice before and after 6 month intervention

change in resting energy expenditure calculated by Weir equation from VO2 and metabolic substrate preference RQ VCO2/VO2 (as measured by indirect calorimetry)

change anthropometric parameters of obesityparameters will be measured twice before and after 6 month intervention

BMI (kg.m-2) , fat mass (% electric bioimpedance), lean body mass (% electric bioimpedance), visceral adiposity (%, elecgtric bioimpedance)

Secondary Outcome Measures
NameTimeMethod
change in quality of life for cancer patientsmeasured twice before and after 6 month intervention

validated questionnaire

change in muscle strengthmeasured twice before and after 6 month intervention

dynamometry

change in cognitive functionsmeasured twice before and after 6 month intervention

standardised cognitive test Cogstate

Trial Locations

Locations (2)

National Cancer Institute

🇸🇰

Bratislava, Please Select, Slovakia

Biomedical Research Center Slovak Academy of Sciences

🇸🇰

Bratislava, Please Select, Slovakia

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